U.S. patent application number 16/984514 was filed with the patent office on 2022-02-10 for triangulation of item in patient body.
The applicant listed for this patent is MAZOR ROBOTICS LTD.. Invention is credited to Gal Barazani, Ofir Dahan, Aviv Ellman, Gal Eshed, Dvir Kadshai, Amir Keret, Dor Kopito, Nir Ofer, Yair Schwartz, Ziv Seemann, Arie Shneiderman, Maor Sviri, Adi Talmor, Ron Visbrot.
Application Number | 20220039871 16/984514 |
Document ID | / |
Family ID | 1000005037460 |
Filed Date | 2022-02-10 |
United States Patent
Application |
20220039871 |
Kind Code |
A1 |
Ofer; Nir ; et al. |
February 10, 2022 |
TRIANGULATION OF ITEM IN PATIENT BODY
Abstract
A surgical positioning system includes an emitter secured to a
medical implant; at least three microphones; at least one
processor; and a memory. The emitter has a speaker and a power
source. The memory stores instructions for execution by the
processor that, when executed, cause the processor to receive, from
each of the at least three microphones, information about a
detected sound; and calculate, based on position information
corresponding to each of the at least three microphones and the
received information, a position of the implant.
Inventors: |
Ofer; Nir; (Tel Aviv-Yafo,
IL) ; Seemann; Ziv; (Beit Ytzhack, IL) ;
Kopito; Dor; (Kibbutz Parod, IL) ; Schwartz;
Yair; (Raanana, IL) ; Dahan; Ofir; (Haifa,
IL) ; Eshed; Gal; (Atlit, IL) ; Kadshai;
Dvir; (Ramat Gan, IL) ; Keret; Amir; (Atlit,
IL) ; Sviri; Maor; (Haifa, IL) ; Talmor;
Adi; (Giva't Ada, IL) ; Visbrot; Ron; (Hadera,
IL) ; Shneiderman; Arie; (Beit Rimon, IL) ;
Ellman; Aviv; (Kfar Sava, IL) ; Barazani; Gal;
(Haifa, IL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
MAZOR ROBOTICS LTD. |
Caesarea |
|
IL |
|
|
Family ID: |
1000005037460 |
Appl. No.: |
16/984514 |
Filed: |
August 4, 2020 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2034/2063 20160201;
A61B 34/20 20160201; A61B 2034/105 20160201; G01S 5/01 20200501;
G01S 5/30 20130101; A61B 34/10 20160201 |
International
Class: |
A61B 34/20 20060101
A61B034/20; G01S 5/30 20060101 G01S005/30; G01S 5/00 20060101
G01S005/00; A61B 34/10 20060101 A61B034/10 |
Claims
1. A surgical positioning system, comprising: an emitter secured to
a medical implant, comprising: a speaker; and a power source; at
least three microphones; at least one processor; and a memory
storing instructions for execution by the processor that, when
executed, cause the processor to: receive, from each of the at
least three microphones, information about a detected sound; and
calculate, based on position information corresponding to each of
the at least three microphones and the received information, a
position of the implant.
2. The surgical positioning system of claim 1, wherein the memory
stores additional instructions for execution by the at least one
processor that, when executed, further cause the at least one
processor to: receive a model of a portion of a patient's anatomy;
and calculate, based on the model, a predicted speed of sound
through at least a segment of the portion of the patient's
anatomy.
3. The surgical positioning system of claim 2, wherein the memory
stores additional instructions for execution by the at least one
processor that, when executed, further cause the at least one
processor to: update the predicted speed of sound based on
calibration data corresponding to a calibration sound generated by
the emitter and detected by each of the at least three
microphones.
4. The surgical positioning system of claim 3, wherein the
calculating the position of the implant is further based on the
updated predicted speed of sound.
5. The surgical positioning system of claim 2, wherein each of the
at least three microphones is mounted in a fixed position relative
to any others of the at least three microphones.
6. The surgical positioning system of claim 1, wherein the detected
sound has a frequency less than 20 kHz.
7. The surgical positioning system of claim 1, wherein the detected
sound has a frequency less than 20 Hz.
8. The surgical positioning system of claim 1, wherein at least one
of the at least three microphones is mounted to a movable arm, and
the memory stores additional instructions for execution by the at
least one processor that, when executed, further cause the at least
one processor to: receive arm position data corresponding to a
position of the movable arm; and calculate, based at least in part
on the arm position data, a location of each of the at least three
microphones.
9. The surgical positioning system of claim 1, wherein the position
information for each of the at least three microphones comprises
data about a position of each of the at least three microphones
relative to the others of the at least three microphones, and the
calculated emitter position is relative to the positions of the at
least three microphones.
10. The surgical positioning system of claim 1, wherein the
position information for each of the at least three microphones is
relative to a common coordinate system.
11. The surgical positioning system of claim 1, wherein the emitter
comprises a plurality of speakers, each speaker is configured to
emit sound at a different frequency than the other speakers in the
plurality of speakers, the received information comprises
information about a detected sound generated by each of the
plurality of speakers, respectively, and the memory stores
additional instructions for execution by the at least one processor
that, when executed, further cause the at least one processor to:
determine an orientation of the implant based at least in part on
the received information.
12. A method of locating an object during a surgery, comprising:
receiving a model of a portion of a patient's anatomy; receiving a
surgical plan comprising information about a planned position of an
implant within the portion of the patient's anatomy; calculating,
based on the planned position of the implant and the model, a
predicted speed of sound along at least one path that extends at
least partially through the portion of the patient's anatomy;
receiving, from at least three microphones, detection information
about a detected sound generated by a speaker secured to the
implant; and determining, based on the predicted speed of sound and
the detection information, a position of the implant.
13. The method of claim 12, wherein the detection information
comprises first detection information about a first detected sound
generated by the speaker at a first time, the method further
comprising: receiving, from the at least three microphones, second
detection information about a second detected sound generated by
the speaker, the second detected sound generated at a second time
after the first time; and determining, based on first detection
information and the second detection information, a movement of the
implant.
14. The method of claim 12, wherein the detection information
corresponds to detected sounds generated by a plurality of speakers
secured to the implant, the method further comprising: determining,
based on the predicted speed of sound and the detection
information, an orientation of the implant.
15. The method of claim 14, wherein each of the detected sounds has
a unique frequency relative to any others of the detected
sounds.
16. The method of claim 12, wherein the determining is further
based on location information corresponding to a location of each
of the at least three microphones.
17. The method of claim 12, wherein the detection information
comprises first detection information about a first detected sound
generated by the speaker at a first time, the method further
comprising: receiving, from the at least three microphones, second
detection information about a second detected sound generated by a
second speaker affixed to an anatomical element of the patient; and
determining, based on first detection information and the second
detection information, a position of the implant relative to the
anatomical element.
18. A surgical triangulation system comprising: a plurality of
microphones configured to be installed in fixed locations about an
operating room; an emitter configured to be secured to an internal
anatomical feature of a patient or an implant, the emitter
comprising: a speaker; and a power source; at least one processor;
and a memory storing instructions for execution by the at least one
processor that, when executed, cause the at least one processor to:
receive a surgical plan comprising information about a portion of
the patient's anatomy; receive, from the plurality of microphones,
sound information about a sound detected by the plurality of
microphones and generated by the speaker; and calculate, based on
the surgical plan, the sound information, and information about the
fixed locations of the plurality of microphones, a position of the
emitter.
19. The surgical triangulation system of claim 18, wherein the
emitter is biocompatible.
20. The surgical triangulation system of claim 18, wherein emitter
comprises a second speaker, and the memory stores additional
instructions for execution by the at least one processor that, when
executed, further cause the at least one processor to: receive,
from the plurality of microphones, second sound information about a
second sound detected by the plurality of microphones and generated
by the second speaker; and calculate, based on the surgical plan,
the second sound information, and the information about the fixed
locations of the plurality of microphones, an orientation of the
emitter.
Description
FIELD
[0001] The present technology generally relates to surgery, and
relates more particularly to object location and tracking during
surgery.
BACKGROUND
[0002] X-ray imaging is used determine the position of an object
that is within a patient's body and therefore not optically
visible, including both anatomical features of the patient (e.g.,
bones or features thereof) and medical devices (e.g., implants,
tools). Navigation systems may be used to determine the position of
such objects if a reference marker is secured to the object and
extends out of the body, so as to be visible to a navigation
camera.
SUMMARY
[0003] Aspects of the present disclosure include:
[0004] A surgical positioning system, comprising: an emitter
secured to a medical implant; at least three microphones; at least
one processor; and a memory. The emitter comprises a speaker and a
power source. The memory stores instructions for execution by the
processor that, when executed, cause the processor to: receive,
from each of the at least three microphones, information about a
detected sound; and calculate, based on position information
corresponding to each of the at least three microphones and the
received information, a position of the implant.
[0005] Any of the aspects herein, wherein the memory stores
additional instructions for execution by the at least one processor
that, when executed, further cause the at least one processor to:
receive a model of a portion of a patient's anatomy; and calculate,
based on the model, a predicted speed of sound through at least a
segment of the portion of the patient's anatomy.
[0006] Any of the aspects herein, wherein the memory stores
additional instructions for execution by the at least one processor
that, when executed, further cause the at least one processor to
update the predicted speed of sound based on calibration data
corresponding to a calibration sound generated by the emitter and
detected by each of the at least three microphones.
[0007] Any of the aspects herein, wherein the calculating the
position of the implant is further based on the updated predicted
speed of sound.
[0008] Any of the aspects herein, wherein each of the at least
three microphones is mounted in a fixed position relative to any
others of the at least three microphones.
[0009] Any of the aspects herein, wherein the detected sound has a
frequency less than 20 kHz.
[0010] Any of the aspects herein, wherein the detected sound has a
frequency less than 20 Hz.
[0011] Any of the aspects herein, wherein at least one of the at
least three microphones is mounted to a movable arm, and the memory
stores additional instructions for execution by the at least one
processor that, when executed, further cause the at least one
processor to: receive arm position data corresponding to a position
of the movable arm; and calculate, based at least in part on the
arm position data, a location of each of the at least three
microphones.
[0012] Any of the aspects herein, wherein the position information
for each of the at least three microphones comprises data about a
position of each of the at least three microphones relative to the
others of the at least three microphones, and the calculated
emitter position is relative to the positions of the at least three
microphones.
[0013] Any of the aspects herein, wherein the position information
for each of the at least three microphones is relative to a common
coordinate system.
[0014] Any of the aspects herein, wherein the emitter comprises a
plurality of speakers, each speaker is configured to emit sound at
a different frequency than the other speakers in the plurality of
speakers, the received information comprises information about a
detected sound generated by each of the plurality of speakers,
respectively, and the memory stores additional instructions for
execution by the at least one processor that, when executed,
further cause the at least one processor to determine an
orientation of the implant based at least in part on the received
information.
[0015] A method of locating an object during a surgery, comprising:
receiving a model of a portion of a patient's anatomy; receiving a
surgical plan comprising information about a planned position of an
implant within the portion of the patient's anatomy; calculating,
based on the planned position of the implant and the model, a
predicted speed of sound along at least one path that extends at
least partially through the portion of the patient's anatomy;
receiving, from at least three microphones, detection information
about a detected sound generated by a speaker secured to the
implant; and determining, based on the predicted speed of sound and
the detection information, a position of the implant.
[0016] Any of the aspects herein, wherein the detection information
comprises first detection information about a first detected sound
generated by the speaker at a first time, and further comprising:
receiving, from the at least three microphones, second detection
information about a second detected sound generated by the speaker,
the second detected sound generated at a second time after the
first time; and determining, based on first detection information
and the second detection information, a movement of the
implant.
[0017] Any of the aspects herein, wherein the detection information
corresponds to detected sounds generated by a plurality of speakers
secured to the implant, and further comprising: determining, based
on the predicted speed of sound and the detection information, an
orientation of the implant.
[0018] Any of the aspects herein, wherein each of the detected
sounds has a unique frequency relative to any others of the
detected sounds.
[0019] Any of the aspects herein, wherein the determining is
further based on location information corresponding to a location
of each of the at least three microphones.
[0020] Any of the aspects herein, wherein the detection information
comprises first detection information about a first detected sound
generated by the speaker at a first time, the method further
comprising: receiving, from the at least three microphones, second
detection information about a second detected sound generated by a
second speaker affixed to an anatomical element of the patient; and
determining, based on first detection information and the second
detection information, a position of the implant relative to the
anatomical element.
[0021] A surgical triangulation system comprising: a plurality of
microphones configured to be installed in fixed locations about an
operating room; an emitter configured to be secured to an internal
anatomical feature of a patient or an implant; at least one
processor; and a memory. The emitter comprises a speaker and a
power source. The memory stores instructions for execution by the
at least one processor that, when executed, cause the at least one
processor to: receive a surgical plan comprising information about
a portion of the patient's anatomy; receive, from the plurality of
microphones, sound information about a sound detected by the
plurality of microphones and generated by the speaker; and
calculate, based on the surgical plan, the sound information, and
information about the fixed locations of the plurality of
microphones, a position of the emitter.
[0022] Any of the aspects herein, wherein the emitter is
biocompatible.
[0023] Any of the aspects herein, wherein the emitter comprises a
second speaker, and the memory stores additional instructions for
execution by the at least one processor that, when executed,
further cause the at least one processor to: receive, from the
plurality of microphones, second sound information about a second
sound detected by the plurality of microphones and generated by the
second speaker; and calculate, based on the surgical plan, the
second sound information, and the information about the fixed
locations of the plurality of microphones, an orientation of the
emitter.
[0024] The details of one or more aspects of the disclosure are set
forth in the accompanying drawings and the description below. Other
features, objects, and advantages of the techniques described in
this disclosure will be apparent from the description and drawings,
and from the claims.
[0025] The phrases "at least one", "one or more", and "and/or" are
open-ended expressions that are both conjunctive and disjunctive in
operation. For example, each of the expressions "at least one of A,
B and C", "at least one of A, B, or C", "one or more of A, B, and
C", "one or more of A, B, or C" and "A, B, and/or C" means A alone,
B alone, C alone, A and B together, A and C together, B and C
together, or A, B and C together. When each one of A, B, and C in
the above expressions refers to an element, such as X, Y, and Z, or
class of elements, such as X.sub.1-X.sub.n, Y.sub.1-Y.sub.m, and
Z.sub.1-Z.sub.o, the phrase is intended to refer to a single
element selected from X, Y, and Z, a combination of elements
selected from the same class (e.g., X.sub.1 and X.sub.2) as well as
a combination of elements selected from two or more classes (e.g.,
Y.sub.1 and Z.sub.o).
[0026] The term "a" or "an" entity refers to one or more of that
entity. As such, the terms "a" (or "an"), "one or more" and "at
least one" can be used interchangeably herein. It is also to be
noted that the terms "comprising", "including", and "having" can be
used interchangeably.
[0027] The preceding is a simplified summary of the disclosure to
provide an understanding of some aspects of the disclosure. This
summary is neither an extensive nor exhaustive overview of the
disclosure and its various aspects, embodiments, and
configurations. It is intended neither to identify key or critical
elements of the disclosure nor to delineate the scope of the
disclosure but to present selected concepts of the disclosure in a
simplified form as an introduction to the more detailed description
presented below. As will be appreciated, other aspects,
embodiments, and configurations of the disclosure are possible
utilizing, alone or in combination, one or more of the features set
forth above or described in detail below.
[0028] Numerous additional features and advantages of the present
invention will become apparent to those skilled in the art upon
consideration of the embodiment descriptions provided
hereinbelow.
BRIEF DESCRIPTION OF THE DRAWINGS
[0029] The accompanying drawings are incorporated into and form a
part of the specification to illustrate several examples of the
present disclosure. These drawings, together with the description,
explain the principles of the disclosure. The drawings simply
illustrate preferred and alternative examples of how the disclosure
can be made and used and are not to be construed as limiting the
disclosure to only the illustrated and described examples. Further
features and advantages will become apparent from the following,
more detailed, description of the various aspects, embodiments, and
configurations of the disclosure, as illustrated by the drawings
referenced below.
[0030] FIG. 1A is a block diagram of a system according to at least
one embodiment of the present disclosure;
[0031] FIG. 1B is a block diagram of an emitter according to at
least one embodiment of the present disclosure;
[0032] FIG. 2 is an illustration of an operating room;
[0033] FIG. 3 is a flowchart of a method according to at least one
embodiment of the present disclosure; and
[0034] FIG. 4 is another flowchart of a method according to at
least one embodiment of the present disclosure.
DETAILED DESCRIPTION
[0035] It should be understood that various aspects disclosed
herein may be combined in different combinations than the
combinations specifically presented in the description and
accompanying drawings. It should also be understood that, depending
on the example or embodiment, certain acts or events of any of the
processes or methods described herein may be performed in a
different sequence, and/or may be added, merged, or left out
altogether (e.g., all described acts or events may not be necessary
to carry out the disclosed techniques according to different
embodiments of the present disclosure). In addition, while certain
aspects of this disclosure are described as being performed by a
single module or unit for purposes of clarity, it should be
understood that the techniques of this disclosure may be performed
by a combination of units or modules associated with, for example,
a computing device and/or a medical device.
[0036] In one or more examples, the described methods, processes,
and techniques may be implemented in hardware, software, firmware,
or any combination thereof. If implemented in software, the
functions may be stored as one or more instructions or code on a
computer-readable medium and executed by a hardware-based
processing unit. Computer-readable media may include non-transitory
computer-readable media, which corresponds to a tangible medium
such as data storage media (e.g., RAM, ROM, EEPROM, flash memory,
or any other medium that can be used to store desired program code
in the form of instructions or data structures and that can be
accessed by a computer).
[0037] Instructions may be executed by one or more processors, such
as one or more digital signal processors (DSPs), general purpose
microprocessors (e.g., Intel Core i3, i5, i7, or i9 processors;
Intel Celeron processors; Intel Xeon processors; Intel Pentium
processors; AMD Ryzen processors; AMD Athlon processors; AMD Phenom
processors; Apple A10 or 10X Fusion processors; Apple A11, A12,
A12X, A12Z, or A13 Bionic processors; or any other general purpose
microprocessors), application specific integrated circuits (ASICs),
field programmable logic arrays (FPGAs), or other equivalent
integrated or discrete logic circuitry. Accordingly, the term
"processor" as used herein may refer to any of the foregoing
structure or any other physical structure suitable for
implementation of the described techniques. Also, the techniques
could be fully implemented in one or more circuits or logic
elements.
[0038] Before any embodiments of the disclosure are explained in
detail, it is to be understood that the disclosure is not limited
in its application to the details of construction and the
arrangement of components set forth in the following description or
illustrated in the drawings. The disclosure is capable of other
embodiments and of being practiced or of being carried out in
various ways. Also, it is to be understood that the phraseology and
terminology used herein is for the purpose of description and
should not be regarded as limiting. The use of "including,"
"comprising," or "having" and variations thereof herein is meant to
encompass the items listed thereafter and equivalents thereof as
well as additional items. Further, the present disclosure may use
examples to illustrate one or more aspects thereof. Unless
explicitly stated otherwise, the use or listing of one or more
examples (which may be denoted by "for example," "by way of
example," "e.g.," "such as," or similar language) is not intended
to and does not limit the scope of the present disclosure.
[0039] Existing methods of locating an object within a patient's
body--whether the object is a foreign object, such as a medical
device or tool (including, for example, a medical implant), or a
native object, such as an anatomical feature of the patient
(including, for example, a bone or organ within the
patient)--include x-ray imaging, which exposes the patient and the
operating room staff to harmful radiation, and ultrasound imaging,
which requires an ultrasound probe to be positioned adjacent the
patient's skin and aimed at the object in question. There remains a
need, for example, to locate an object within a patient's body
without the use of a system or device that emits harmful radiation,
and more conveniently than may be accomplished using
ultrasound.
[0040] According to some embodiments of the present disclosure, a
small chip or resonance item (which may be, for example, a speaker)
may be attached, affixed, or otherwise secured to an object to be
traced or tracked, such as a medical implant, a medical tool, a
bone, or any other object within (or to be placed within) the
patient's body. In some embodiments, the small chip may be
removably secured to the object, while in other embodiments, the
small chip may be permanently secured to the object, contained
within the object, or otherwise configured to remain on or within
the object. Also according to some embodiments of the present
disclosure, a plurality of devices may be positioned outside of the
patient's body, and configured to send and/or receive one or more
signals from the small chip or resonance item. For example, in
embodiments where the small chip or resonance item is or comprises
a speaker, each of the plurality of devices may be a microphone.
The plurality of devices may be positioned at known locations
relative to each other, and/or at known locations within a common
coordinate system. Each of the plurality of devices may comprise
one or more sensors for accurately measuring a distance to any
others of the plurality of devices or for determining a position
thereof within a coordinate system. Each of the plurality of
devices may be secured in a fixed location, or one or more of the
plurality of devices may be movable. In the latter instance, a
position of each of the plurality of devices (or at least of any
movable device) may be determined after the device is moved,
whether using one or more sensors on the device itself, one or more
sensors on an arm or other object that is holding the device, or
otherwise.
[0041] The plurality of devices may transmit a signal to the small
chip or resonance item, which may return the signal (or transmit
another signal in response to the first signal). Upon receipt of
the return or other signal from the small chip or resonance item by
the plurality of devices, a processor may be used to triangulate
the position of the small chip or resonance item (e.g., based on
the time of flight of the signals, or otherwise). Error in the
system may be reduced by increasing the number of the plurality of
devices, and/or by adding more small chips or resonance items to
the object.
[0042] According to at least one embodiment of the present
disclosure, ultrasound may be used for triangulation. Ultrasound
has good angular accuracy. In embodiments that use ultrasound, a
truss with a flexible joint and one or more encoders may be used to
achieve accuracy.
[0043] According to at least another embodiment of the present
disclosure, wireless signals may be used for triangulation,
including radio frequency signals, WiFi signals, ZigBee signals,
Bluetooth signals, Bluetooth low energy signals, Bluetooth beacon
signals, GSM signals, LTE signals, and signals using any other
wireless communication protocol. In some embodiments, no wireless
communication protocol is needed. A plurality of transceivers may
be located outside of the patient's body, and configured to ping
the small chip or resonance item inside of the patient's body, then
receive a return signal from the small chip or resonance item.
Error can be reduced by changing which one of the plurality of
transceivers transmits the signal and by using all of the
transceivers in the array to receive the return signal. High-speed
processing may be utilized to facilitate triangulation using
wireless signals (or any other method of triangulation described
herein).
[0044] According to at least another embodiment of the present
disclosure, triangulation may be accomplished using sound. For
example, a small ceramic `speaker` may be placed on an implant or
medical tool or other element to be tracked. An array of
microphones may be positioned outside of the patient's body, each
microphone configured to detect sound waves at the frequency or
frequencies at which the speaker is configured to generate such
sound waves. One or more frequencies may be chosen, for example,
based on which frequencies move best through anatomical tissue.
Multiple frequencies may be used to achieve better accuracy.
[0045] According to still other embodiments of the present
disclosure, a plurality of triangulation methods may be used
simultaneously or together to improve accuracy. Additionally, in
some embodiments the small chip or resonance item may be passive
(e.g., configured only to reflect signals generated outside the
patient's body) or active (e.g., configured to generate signals
that may be detected outside the patient's body). Accuracy may be
increased by increasing the number of devices positioned outside of
the patient's body, and/or by utilizing a plurality of small chips
or resonance items on the implant, tool, or other item inside the
patient's body.
[0046] Embodiments of the present disclosure beneficially enable
more accurate placement of implants and tools in a patient's body.
Embodiments of the present disclosure also beneficially enable
position determination and tracking without exposing the patient or
any attending physicians or other operating room staff to harmful
radiation. Embodiments of the present disclosure further
beneficially enable position determination and tracking without
requiring a line of sign to the tracked object or to a reference
marker attached to the tracked object.
[0047] Turning first to FIG. 1A, a block diagram of a system 100
according to at least one embodiment of the present disclosure is
shown. The system 100 may be used, for example: to locate an object
within a patient's body, whether that object is a foreign object
(e.g., a medical tool, implant, or other device) or an anatomical
feature of the patient (e.g., a bone or organ); to determine an
orientation of an object within a patient's body; to detect
movement or relative movement of an object within a patient's body;
for autonomous surgery; for robot-assisted surgery; to calibrate a
triangulation system; to verify the operational integrity of a
navigation system using an independent triangulation system and/or
vice versa; to carry out one or more aspects of one or more of the
methods disclosed herein; or for any other useful purpose. The
system 100 comprises a computing device 102, a plurality of sensors
132, a robot 136, an emitter 156, a navigation system 160, a
database 164, and a cloud 168. Notwithstanding the foregoing,
systems according to other embodiments of the present disclosure
may omit any one or more of the computing device 102, the plurality
of sensors 132, the robot 136, the emitter 156, the navigation
system 160, the database 164, and/or the cloud 168. Additionally,
systems according to other embodiments of the present disclosure
may arrange one or more components of the system 100 differently
(e.g., one or more of the plurality of sensors 132, the robot 136,
and the navigation system 160 may comprise the components shown in
FIG. 1A as being part of the computing device 102).
[0048] The computing device 102 comprises at least one processor
104, at least one communication interface 108, at least one user
interface 112, and at least one memory 116. A computing device
according to other embodiments of the present disclosure may omit
one or both of the communication interface(s) 108 and the user
interface(s) 112.
[0049] The at least one processor 104 of the computing device 102
may be any processor identified or described herein or any similar
processor. The at least one processor 104 may be configured to
execute instructions stored in the at least one memory 116, which
instructions may cause the at least one processor 104 to carry out
one or more computing steps utilizing or based on data received,
for example, from the plurality of sensors 132, the robot 136, the
emitter 156, the navigation system 160, the database 164, and/or
the cloud 168.
[0050] The computing device 102 may also comprise at least one
communication interface 108. The at least one communication
interface 108 may be used for receiving image data or other
information from an external source (such as the plurality of
sensors 132, the robot 136, the navigation system 160, the database
164, the cloud 168, and/or a portable storage medium (e.g., a USB
drive, a DVD, a CD)), and/or for transmitting instructions, images,
or other information from the at least one processor 104 and/or the
computing device 102 more generally to an external system or device
(e.g., another computing device 102, the robot 136, the navigation
system 160, the database 164, the cloud 168, and/or a portable
storage medium (e.g., a USB drive, a DVD, a CD)). The at least one
communication interface 108 may comprise one or more wired
interfaces (e.g., a USB port, an ethernet port, a Firewire port)
and/or one or more wireless interfaces (configured, for example, to
transmit information via one or more wireless communication
protocols such as 802.11a/b/g/n, Bluetooth, Bluetooth low energy,
NFC, ZigBee, and so forth). In some embodiments, the at least one
communication interface 108 may be useful for enabling the device
102 to communicate with one or more other processors 104 or
computing devices 102, whether to reduce the time needed to
accomplish a computing-intensive task or for any other reason.
[0051] The at least one user interface 112 may be or comprise a
keyboard, mouse, trackball, monitor, television, touchscreen,
button, joystick, switch, lever, and/or any other device for
receiving information from a user and/or for providing information
to a user of the computing device 102. The at least one user
interface 112 may be used, for example, to receive a user selection
or other user input in connection with any step of any method
described herein; to receive a user selection or other user input
regarding one or more configurable settings of the computing device
102 and/or of another component of the system 100; to receive a
user selection or other user input regarding how and/or where to
store and/or transfer data received, modified, and/or generated by
the computing device 102; and/or to display information (e.g.,
text, images) and/or play a sound to a user based on data received,
modified, and/or generated by the computing device 102.
Notwithstanding the inclusion of the at least one user interface
112 in the system 100, the system 100 may automatically (e.g.,
without any input via the at least one user interface 112 or
otherwise) carry out one or more, or all, of the steps of any
method described herein.
[0052] Although the at least one user interface 112 is shown as
part of the computing device 102, in some embodiments, the
computing device 102 may utilize a user interface 112 that is
housed separately from one or more remaining components of the
computing device 102. In some embodiments, the user interface 112
may be located proximate one or more other components of the
computing device 102, while in other embodiments, the user
interface 112 may be located remotely from one or more other
components of the computer device 102.
[0053] The at least one memory 116 may be or comprise RAM, DRAM,
SDRAM, other solid-state memory, any memory described herein, or
any other tangible non-transitory memory for storing
computer-readable data and/or instructions. The at least one memory
116 may store information or data useful for completing, for
example, any step of the methods 300 and/or 400 described herein.
The at least one memory 116 may store, for example, information
about one or more predetermined coordinate systems 120 (e.g.,
information about a robotic coordinate system or space, information
about a navigation coordinate system or space, information about a
patient coordinate system or space); instructions 124 for execution
by the at least one processor 104, for example to cause the at
least one processor 104 to carry out one or more of the steps of
the method 300 and/or of the method 400; and/or one or more
algorithms 128 for use by the processor in carrying out any
calculations necessary to complete one or more of the steps of the
method 300 and/or of the method 400, or for any other calculations.
Such predetermined coordinate system(s) 120, instructions 124,
and/or algorithms 128 may, in some embodiments, be organized into
one or more applications, modules, packages, layers, or engines,
and may cause the at least one processor 104 to manipulate data
stored in the at least one memory 116 and/or received from or via
another component of the system 100.
[0054] The plurality of sensors 132 are configured to detect one or
more signals generated or reflected by the emitter 156. The
plurality of sensors may be positioned at fixed and known locations
on or around an operating table, within an operating room, on one
or more stands or other objects within an operating room, and/or in
any other location suitable for receiving and/or detecting one or
more signals generated or reflected by the emitter 156. In some
embodiments, the plurality of sensors 132 comprises at least one
sensor 132 configured to generate a signal, which may then be
reflected by the emitter 156 and detected or otherwise received by
the plurality of sensors 132. In some embodiments, the plurality of
sensors may comprise three sensors. In other embodiments, the
plurality of sensors may comprise more than three sensors. The
sensors may be spread around an operating room or other surgical
environment to increase a likelihood that at least three sensors of
the plurality of sensors 132 will detect or receive a signal from
the emitter 156. In some embodiments, one or more of the plurality
of sensors 132 may be positioned on or adjacent a patient's skin,
while in other embodiments, none of the plurality of sensors 132
may be positioned on or adjacent to the patient's skin. The
plurality of sensors 132 may be or comprise microphones, wireless
receivers or transceivers (configured, for example, to receive
radio frequency signals of any variety or generated using any
protocol or no protocol), ultrasound probes, RADAR probes, SONAR
probes, any other device capable of receiving a signal, and/or any
combination of two or more of the foregoing.
[0055] The plurality of sensors 132 may be or comprise directional
sensors configured to determine a direction from which a signal is
detected.
[0056] Although not shown in the figures, in some embodiments, the
system 100 may comprise a plurality of emitters 156 and a single
sensor 132, and the single sensor 132 may be configured to be
placed within a patient's body to detect a signal generated or
reflected by the plurality of emitters 156 and to communicate,
whether via the sensors 132, the communication interface(s) 108, or
otherwise, with the computing device 102.
[0057] In embodiments where the plurality of sensors 132 are
located in fixed positions (e.g., mounted to a wall, ceiling,
and/or floor of an operating room, and/or to a fixed operating
table, or to one or more non-moveable stands or structures),
information about the fixed positions in which the plurality of
sensors 132 are located may be stored, for example, in the memory
116. Such information may be relative to one or more predetermined
coordinate system(s) 120 stored in the memory 116.
[0058] In some embodiments, one or more of the plurality of sensors
132 may be moveable, whether by virtue of being secured to or held
by a moveable stand, secured to or held by a robotic arm or an
articulated arm, or otherwise. In embodiments where one or more of
the plurality of sensors 132 are secured to or held by a robotic
arm, the robotic arm may be precisely moveable (e.g., such that the
precise position of a given point on the robotic arm is known at
any given time during operation thereof), so that a position of the
one or more sensors 132 is known regardless of the pose of the
robotic arm. In embodiments of the present disclosure comprising
one or more moveable sensors 132, the location of any such moveable
sensors 132 may be determined once the sensor 132 is positioned
(and, thereafter, any time the moveable sensor 132 is
repositioned), whether using one more sensors on the moveable
stand, the robotic arm or articulated arm, or otherwise; using
manual measuring techniques; using a calibration process (which may
or may not utilize triangulation methods); or otherwise.
[0059] The greater the number of sensors included in the plurality
of sensors 132, the greater the accuracy of any triangulation
calculations may be. Additionally, the more spread out the sensors
included in the plurality of sensors 132, the greater the accuracy
of any triangulation calculations may be. The plurality of sensors
132 may comprise at least three sensors, or at least four sensors,
or at least five sensors, or at least ten sensors.
[0060] Although shown in FIG. 1A as being in communication only
with the computing device 102, in some embodiments, the plurality
of sensors 132 may be in communication with any one or more of the
computing device 102, the robot 136, the navigation system 160, the
database 164, and/or the cloud 168.
[0061] The plurality of sensors 132 may be configured to receive
and/or detect only signals generated or reflected by the emitter
156. For example, where the plurality of sensors 132 comprises one
or more microphones and the emitter 156 comprises one or more
speakers, the one or more microphones may be configured to receive
or detect only sounds at one or more specific frequencies. Such a
configuration of the plurality of sensors 132 may beneficially
reduce the amount of noise detected by the plurality of sensors
132, reduce the amount of processing power needed to interpret any
received or detected signals, and/or improve the accuracy of the
results of any triangulation process. The plurality of sensors 132
may be configured to continuously receive and/or detect signals
from the emitter 156, or may be configured to receive and/or detect
such signals only when activated (whether manually or autonomously,
or according to a predetermined schedule), or otherwise.
[0062] The robot 136 may be any surgical robot or surgical robotic
system. The robot 136 may be or comprise, for example, the Mazor
X.TM. Stealth Edition robotic guidance system. The robot 136 may
comprise a base 140 that supports a single robotic arm 144. The
robot 136 may comprise one or more robotic arms 144. In some
embodiments, the robotic arm 144 may comprise a first robotic arm
and a second robotic arm. In other embodiments, the robot 136 may
comprise more than two robotic arms 144. The robotic arm 144 may,
in some embodiments, assist with a surgical procedure (e.g., by
holding a tool in a desired trajectory or pose and/or supporting
the weight of a tool while a surgeon or other user operates the
tool, or otherwise) and/or automatically carry out a surgical
procedure.
[0063] The robotic arm 144 may have three, four, five, six, seven,
or more degrees of freedom. The robotic arm 144 may comprise one or
more segments 152. Each segment 152 may be secured to at least one
adjacent member by a joint, such that the robotic arm is
articulated. The joint(s) may be any type of joint that enables
selective movement of the member relative to the structure to which
the joint is attached (e.g., another segment of the robotic arm, or
the base 140). For example, the joint may be a pivot joint, a hinge
joint, a saddle joint, or a ball-and-socket joint. The joint may
allow movement of the member in one dimension or in multiple
dimensions, and/or along one axis or along multiple axes.
[0064] While a proximal end of the robotic arm 144 may be secured
to the base 140 (whether via a joint or otherwise), a distal end of
the robotic arm 144 may support an end effector. The end effector
may be, for example, a tool (e.g., a drill, saw, imaging device) or
a tool guide (e.g., for guiding a biopsy needle, ablation probe, or
other tool along a desired trajectory).
[0065] The robotic arm 144 may comprise one or more pose sensors
148. The pose sensors 148 may be configured to detect a pose of the
robotic arm, and may be or comprise one or more rotary encoders,
linear encoders, incremental encoders, or other sensors. Data from
the pose sensors 148 may be provided to a processor of the robot
136, to the processor 104 of the computing device 102, and/or to
the navigation system 160. The data may be used to calculate a
position in space of the robotic arm 144 relative to a
predetermined coordinate system. Such a calculated position may be
used, for example, to determine a position in space of one or more
of the plurality of sensors 132 that are attached to the robotic
arm 144.
[0066] With reference still to FIG. 1A, and also to FIG. 1B, the
emitter 156 is configured to be attached to a medical implant, a
surgical tool, an anatomical feature of a patient, or any other
object inside or to be placed inside of a patient. The emitter 156
may be configured to generate or reflect one or more signals
receivable and/or detectable by the plurality of sensors 132. In
embodiments where the emitter 156 is configured only to reflect
signals generated by a device other than the emitter 156, the
emitter 156 may be passive and/or unpowered, and may be made of a
material and/or fashioned with a shape that will enhance
reflectivity thereof. For example, the emitter 156 may be
configured to reflect ultrasound waves, or to reflect radio
frequency waves, or as a RADAR target or a SONAR target. In such
embodiments, the emitter 156 may be unpowered.
[0067] In embodiments where the emitter 156 is configured to
generate one or more waves or other signals, the emitter 156 may be
powered. In such embodiments, the emitter 156 may comprise a power
source 172. The power source 172 may be, for example, a lithium
iodide battery or any other battery or fuel cell suitable for use
and/or implantation in a patient (whether within a protective
housing or otherwise).
[0068] The emitter 156 may also comprise a signal or wave generator
176, which may be a speaker (where sound waves will be used for
triangulation), a radio transmitter (where RF signals will be used
for triangulation), or any other transmitter or generator. Where
the signal generator 176 is a speaker, the speaker may be
configured to generate sound waves at a single frequency, or to
selectively generate sound waves at one of a plurality of
predetermined frequencies. The speaker may be configured to
generate sound waves at any frequency within the sonic spectrum. In
some embodiments, the speaker may be configured to generate sound
waves only at or below the acoustic spectrum (e.g., at frequencies
less than 20 kHz). In other embodiments, the speaker may be
configured to generate sound waves only within the infrasound
spectrum (e.g., lower than 20 Hz). In still other embodiments, the
speaker may be configured to generate sound waves in the ultrasound
spectrum (e.g., higher than 20 kHz). In still other embodiments,
the speaker may be configured to generate sound waves only outside
of the acoustic spectrum (e.g., below 20 Hz and above 20 kHz). Use
of sound waves outside of the acoustic spectrum may beneficially
enable the system 100 to avoid generating sounds that are audible
to operating room staff and/or to avoid sounds generated by
operating room staff from being picked up by the plurality of
sensors 132 and confused (e.g., by the processor 102) for sounds
generated by the emitter 156.
[0069] Where the signal generator 176 is a speaker, the speaker may
be a ceramic speaker. The speaker may be a piezoelectric speaker.
The speaker may have a maximum dimension (e.g., length or width or
height) of less than one quarter of one inch, or of less than half
of one inch, or of less than one inch, or less than one and one
half inches.
[0070] The signal generator 176 may be configured to generate a
signal at a periodic interval (e.g., every second, every five
seconds, every ten seconds, every twenty seconds, every thirty
seconds, every minute, every five minutes, every thirty minutes, or
on any other interval). The signal generator 176 may also be
configured to generate a signal only in response to an external
stimulus (which may be, for example, a signal received from an
external source by the emitter 156). In such embodiments, the
emitter 156 may comprise a receiver configured to receive and/or
detect such signals, and/or a processor or other logic (implemented
in software and/or in hardware) configured to cause the signal
generator 176 to generate a signal in response to receipt of the a
signal. The emitter 156 may also comprise one or more sensors
(e.g., an accelerometer or other sensor) configured to detect a
movement of the emitter 156 and/or any other one or more
environmental characteristics relevant to the emitter 156, and may
comprise a processor or other logic (implemented in software and/or
in hardware) configured to cause the signal generator to generate a
signal in response to one or more predetermined environmental
conditions.
[0071] In some embodiments, the emitter 156 may comprise a
plurality of signal generators 176. In such embodiments, the signal
generators 176 may be positioned as far from each other on or
within the emitter 156 as possible, and may be configured to
generate signals having slightly different characteristics. For
example, where the signal generators 176 are speakers, each speaker
may be configured to generate sound waves having a slightly
different frequency (e.g., one speaker may be configured to
generate a sound wave at 100 Hz, while another may be configured to
generate a sound wave at 102 Hz). Of course, larger variations are
possible as well; one speaker may be configured to generate a sound
wave at 20 Hz, and another may be configured to generate a sound
wave at 20 kHz. In such embodiments, triangulation may be used to
calculate a position of each of the plurality of signal generators
176, and the calculated positions may then be used to determine an
orientation of the emitter 156. As may be appreciated, an
orientation of the emitter 156 determined based on the calculated
positions of two separate signal generators 176 will be less
precise than an orientation of the emitter 156 determined based on
the calculated positions of three or more separate signal
generators 176.
[0072] The emitter 156 may comprise a housing in which the power
source 172 and signal generator 176 are stored. The housing may
protect the power source 172 and the signal generator 176 from
bodily fluids and other environmental conditions internal to the
body of a patient in which the emitter 156 is placed (whether
temporarily or permanently). The housing may also protect the
patient from the power source 172 and/or the signal generator 176.
In some embodiments, the emitter 156 may be biocompatible by virtue
of such a housing, while in other embodiments the components of the
emitter 156 may themselves be biocompatible, and no housing may be
needed.
[0073] The emitter 156 may be or comprise a device or mechanism for
securing the emitter 156 to a medical implant, surgical tool,
anatomical feature, or other object within or to be inserted within
a patient's body. The emitter 156 may be configured to be attached
to such an object using one or more screws or other mechanical
fasteners, or using an adhesive, or using stiches, or using
staples, or using any other fastening or securing mechanism. In
some embodiments, an implant or surgical tool may be manufacturing
with an emitter 156 (or with one or components of an emitter 156)
contained within the implant, such that the implant acts as a
housing for the emitter 156 or for the one or more components
thereof. In some embodiments, the emitter 156 may be configured to
be secured within a hole drilled into or otherwise fashioned in an
implant, tool, anatomical feature, or other object, whether by way
of a friction fit or otherwise. The emitter 156 is configured to be
fixedly secured to an object, so that determination of a position
of the emitter enables determination of a position of the object.
The emitter 156 may be permanently secured to the object, or
removably secured to the object. In some embodiments, the emitter
156 may be safely left within the body of the patient.
[0074] Some embodiments of the system 100 may comprise more than
one emitter 156. In such embodiments, multiple emitters 156 may be
secured to a single object (e.g., to better determine an
orientation of the object), and/or one or more emitters 156 may be
secured to more than one object (e.g., in order to determine a
position of more than one object within the patient's body, and/or
to determine relative movement between or among the more than one
object).
[0075] Referring again to FIG. 1A, the navigation system 160 may
provide navigation for a surgeon and/or for the robot 136 during an
operation or surgical procedure. The navigation system 160 may be
any now-known or future-developed navigation system, including, for
example, the Medtronic StealthStation.TM. S8 surgical navigation
system. The navigation system 160 may include a camera or other
sensor(s) for detecting and/or tracking one or more reference
markers, navigated trackers, or other objects within an operating
room or other room where a surgical procedure takes place. In some
embodiments, the navigation system 160 may comprise the plurality
of sensors 132. In various embodiments, the navigation system 160
may be used to track a position of the robotic arm 144 and/or one
or more other objects to which the navigation system 160 has a line
of sight (where the navigation system is an optical system) or that
are otherwise detectable by the navigation system 160. The
navigation system 160 may be used to track a position of one or
more reference markers or arrays or other structures useful for
detection by a camera or other sensor of the navigation system 160.
The navigation system 160 may include a display for displaying one
or more images from an external source (e.g., the computing device
102, plurality of sensors 132, or other source) or a video stream
from the camera or other sensor of the navigation system 160. In
some embodiments, the system 100 may operate without the use of the
navigation system 160.
[0076] The database 164 may store information about a given
operation or surgical procedure, such as one or more surgical
plans, one or more digital models of a portion of a patient's
anatomy, one or more digital models of implants, tools, or other
objects (anatomical features or foreign objects) that may be
located or positioned within a patient's body, one or more images
of a patient's anatomy, and/or any other useful information. Any
data described above as being stored within the memory 116 may also
or alternatively be stored within the database 164, and vice versa.
The database 164 may be configured to provide any information
stored therein to the computing device 102 or to any other device
of the system 100 or external to the system 100, whether directly
or via the cloud 168. In some embodiments, the database 164 may be
or comprise part of a hospital image storage system and/or
electronic health records system, such as a picture archiving and
communication system (PACS), a health information system (HIS),
and/or another system for collecting, storing, managing, and/or
transmitting electronic medical records including image data.
[0077] The cloud 168 may be or represent the Internet or any other
wide area network. The computing device 102 may be connected to the
cloud 168 via the communication interface 108, using a wired
connection, a wireless connection, or both. In some embodiments,
the computing device 102 may communicate with the database 164
and/or an external device (e.g., a computing device) via the cloud
168.
[0078] Turning now to FIG. 2, a plurality of sensors 212 (which may
be the same as or similar to the plurality of sensors 132) may be
installed in any number of fixed locations around an operating room
200, including for example on an operating table 202 (on which a
patient may lay during a surgical procedure), one or more legs 204
of the operating table 202, a wall 206 or 208 of the operating
room, a floor 210 of the operating room, and/or a ceiling of the
operating room (not shown). The plurality of sensors 212 may be
spread around the operating room to increase an accuracy of any
triangulation calculations. The plurality of sensors 212 may be
positioned to increase a likelihood that at least a minimum number
of sensors 212 (e.g., three sensors 212) will receive and/or detect
a signal generated or reflected by an emitter 156.
[0079] In some embodiments, an array of sensors 212 may be mounted
to a fixed frame that is configured to be mounted to a wall 206 or
208, mounted to or hung from a ceiling of an operating room, or
otherwise positioned within an operating room. The array of sensors
212 may beneficially comprise at least three sensors having known
positions relative to each other, and may therefore facilitate use
of the systems and methods described herein where a plurality of
sensors are not already installed in an operating room or are not
permanently installed in an operating room.
[0080] Turning now to FIG. 3, a method 300 for utilizing a robotic
reference frame for navigation may be performed, for example, by at
least one processor. The at least one processor may be the same as
or similar to the processor(s) 104 of the computing device 102
described above. The at least one processor may be part of a robot
(such as the robot 136) or part of a navigation system (such as the
navigation system 160). A processor other than any processor
described herein may also be used to execute the method 300. The at
least one processor may perform the method 300 by executing
instructions stored in a memory, such as the instructions 124 of
the memory 116. The instructions may correspond to one or more
steps of the method 300 described below. The instructions may cause
the processor to execute one or more algorithms, such as the
algorithms 128.
[0081] The method 300 comprises receiving a model of a portion of a
patient's anatomy (step 304). The model may be a digital, 3D model
of the portion of the patient's anatomy that is relevant to a
planned surgical procedure. For example, if a surgical procedure is
planned for a portion of a patient's spine, that the model may be a
digital, 3D model of the patient's spine or a portion thereof, and
may include details regarding anatomical features around the
patient's spine. As another example, if the surgical procedure is
planned for the patient's abdomen, then the model may be a digital,
3D model of the patient's abdomen, including the patient's organs
located in the abdomen. The model may be generated based on one or
more preoperative images, which may be, for example, CT scans, Mill
images, X-ray images, or other images. The model may have been
generated from a plurality of two-dimensional images. The model may
be received from a database such as the database 164, via the cloud
168, or from another external source. The model may also be
received from a memory such as the memory 116. The model may be
received via a communication interface 108 and/or via a user
interface 112. In some embodiments, the model may be received
directly from an imaging device.
[0082] The method 300 also comprises calculating a predicted speed
of sound through at least a segment of the portion of the patient's
anatomy (step 308). Where sound will be used for triangulation
purposes, a speed of sound through a segment of the patient's
anatomy (e.g., a segment that extends from an emitter located
somewhere within the portion of the patient's anatomy corresponding
to the model received in the step 304, to an outer surface of the
patient's anatomy) may be calculated. The calculating may comprise
determining which materials lie along the segment (e.g., bony
tissue, soft tissue, blood, stomach juices), measuring or otherwise
determining a thickness of depth of each material along the
segment, looking up (e.g., in a look-up table or other database) a
speed of sound through each material, and then calculating a speed
of sound along the entire segment based on the foregoing
information. Thus, as a simple example, if the segment in question
is determined to extend through two inches of bony tissue, one half
inch of fatty tissue, and one sixteenth of an inch of skin tissue,
then the calculating may comprise determining a speed of sound
through each of bony tissue, fatty tissue, and skin tissue, and
then based on the amount of each tissue through which a sound wave
must pass and the determined speed of sound through each type of
tissue, calculating how long it would take a sound wave to travel
through the two inches of bony tissue at the speed of sound through
bony tissue, one half inch of fatty tissue at the speed of sound
through fatty tissue, and one sixteenth inch of skin tissue at the
speed of sound through skin tissue. In some embodiments, an average
speed of sound through anatomical tissue may be calculated, and a
distance through which a sound wave must travel from an emitter
located within the patient's anatomy to a surface of the patient's
body may be divided by the average speed of sound through
anatomical tissue to determine an amount of time that a sound wave
will take to reach the surface of the patient's body.
[0083] In some embodiments, the predicted speed of sound may be
calculated through a plurality of segments of the patient's
anatomy. Also in some embodiments, the calculations may be based on
a general or precise location of one or more of a plurality of
sensors positioned to detect or receive the sound wave. Thus, for
example, if one microphone is positioned directly above an
operating table, and another is positioned directly to the side of
an operating table, then a first predicted speed of sound may be
calculated for a segment of the patient's anatomy that extends from
a planned position of an emitter within the patient's anatomy to a
surface of the patient's anatomy located above the planned position
(e.g., in the direction of the microphone positioned directly above
the operating table), and a second predicted speed of sound may be
calculated for a segment of the patient's anatomy that extends from
the planned position of the emitter to a surface of the patient's
anatomy located to the side of the emitter (e.g., in the direction
of the microphone positioned directly to the side of the operating
table). In other embodiments, an average speed of sound may be
utilized for the calculations of the step 308, and the model may be
used to determine either a precise or an approximate distance
through which a sound wave must travel through the patient's
anatomical tissue before reaching a surface thereof and traveling
through the air in the operating room.
[0084] The method 300 also comprises updating the predicted speed
of sound based on calibration data (step 312). For example, an
emitter such as the emitter 156 may be placed on one side of a
patient's body, and a sensor such as the sensor 212 may be placed
on an opposite side of the patient's body, with a known positional
relationship between the emitter and the sensor. The emitter may
generate a sound at a first known time, which may be detected by
the sensor at a second known time. Based on the first known time,
the second known time, and a known distance between the emitter and
the sensor, a speed of sound through the patient's body may be
calculated, and this calculated speed of sound may be utilized as
calibration data for updating the predicted speed of sound
calculated in the step 308.
[0085] The method 300 also comprises receiving position data
corresponding to a position of each of a plurality of microphones
(step 316). The position data may be relative to a single
coordinate system, and may comprise information about a location of
each of the plurality of microphones within the single coordinate
system. In other embodiments, the position data may be relative to
one or more of the other microphones in the plurality of
microphones, such that a position of each microphone is known
relative to a position of the others of the plurality of
microphones, even if a position of the microphones relative to the
operating room or to a more global coordinate system is not known.
The position data may be comprise information about the actual
position of each of the plurality of microphones, or information
from which the actual position of each of the plurality of
microphones may be calculated. The position data may in some
embodiments comprise information about a pose of robotic or other
articulated arm to which one or more of the plurality of
microphones are attached.
[0086] The method 300 also comprising calculating a position of
each of the plurality of microphones (step 320). Where the position
data received in the step 316 comprises information from which the
actual position of each of the plurality of microphones may be
calculated (including, for example, information about a pose of a
moveable arm from which a position of a microphone attached to the
moveable arm may be calculated), then the step 320 of calculating a
position of each of the plurality of microphones may be completed.
The calculating may use one or more algorithms such as the
algorithms 128 (which may be or comprise, for example, one or more
algebraic, geometric, trigonometric, or other algorithms) to
calculate a position of each of the plurality of microphones,
whether relative to the others of the plurality of microphones or
relative to a single common coordinate system (such as a
predetermined coordinate system 120).
[0087] The method 300 also comprises receiving information about a
detected signal generated by an emitter (step 324). Where, as here,
the emitter is or comprises a speaker and the plurality of sensors
being utilizes is a plurality of microphones, the detected signal
is a sound signal. The detected signal may have a frequency that
corresponds to a frequency to which the plurality of microphones
are tuned or otherwise configured to detect. The detected signal
may have a frequency that corresponds to a sole frequency at which
the emitter is configured to generate sound waves, or a frequency
selected from among a limited set of frequencies at which the
emitter is configured to selectively generate sound waves. The
detected signal may have one or more characteristics intended to
distinguish the detected signal from one or more other sounds in an
operating room environment. In some embodiments, for example, the
detected signal may comprise a single pulse, while in other
embodiments, the detected signal may comprise a series of pulses,
which may or may not be equal in length and in time-spacing from a
previous and/or subsequent pulse. The detected signal may, for
example, have a frequency in the infrasound range or the ultrasound
range, so as not to be heard by operating room staff. The detected
signal may have a frequency in the acoustic range (between the
infrasound and ultrasound ranges), but proximate a boundary of that
range so as to reduce a likelihood that the signal will be heard by
persons in the operating room. The detected signal may have a
frequency selected to avoid interference with one or more
instruments, tools, or other devices or systems in the operating
room environment.
[0088] The information about the detected signal may be received
all at once (e.g., as a collection of data generated by each of the
plurality of microphones), or the information about the detected
signal may be received over time (e.g., data generated by each of
the plurality of microphones may be received based on when each of
the plurality of microphones detects the signal). In the former
instance, the information may comprise data corresponding to a time
at which each of the plurality of microphones detected the signal.
In the latter instance, the information may not comprise data
corresponding to a time at which each of the plurality of
microphones detected the signal.
[0089] Where the plurality of microphones are directional
microphones (e.g., microphones configured to determine a direction
from which a signal is received), the information about the
detected signal may comprise information about the direction from
which the signal was received from each of the plurality of
microphones.
[0090] The emitter may be the same as or substantially similar to,
for example, the emitter 156. The information about the detected
signal may be received from the plurality of microphones, whether
directly or via one or more communication interfaces, such as the
communication interfaces 108. The information may be raw data
corresponding to a detected signal generated by the emitter, or the
information may be processed data corresponding to a detected
signal generated by an emitter. For example, the information may
simply be an electrical signal generated by each of the plurality
of microphones upon the detected signal reaching each of the
plurality of microphones. Alternatively, the information may be or
comprise the result of amplifying, filtering, conditioning, and/or
otherwise processing one or more such electrical signals.
[0091] The method 300 also comprises calculating a position of the
emitter (step 328). The calculating may be based on the information
received in the step 324. Where the information does not comprise
data corresponding to a time at which each of the plurality of
microphones detected the signal, the calculating may also be based
on a time at which data from each of the plurality of microphones
was received. The calculating may also be based on a predicted
speed of sound calculated in the step 308, the updated predicted
speed of sound from the step 312, and/or the model received in the
step 304. The calculating may further be based on the position of
each of the plurality of microphones, as received in the step 316
or as calculated in the step 320. The calculating may utilize one
or more algorithms 128, including, for example, one or more
trigonometric, geometric, or other mathematical equations or
functions. The calculating comprises using triangulation methods
based on known distances between or among the microphones as well
as information about the speed of sound through one or more media
to determine a position of the emitter (and thus of the implant,
tool, anatomical feature, or other object to which the emitter is
attached or otherwise secured).
[0092] The method 300 also comprises determining an orientation of
the implant (step 332). Where the emitter comprises a plurality of
speakers, each speaker may generate a signal (e.g., a sound wave),
and each signal may be detected by the plurality of microphones.
The signals may differ from each other in at least one
characteristic, such that each signal can be distinguished from the
other signals. A position of each speaker may then be calculated
according to the step 328, and the calculated speaker positions may
be used--together with information about, for example, a position
of each speaker within or on the emitter--to determine an
orientation of the emitter. Where the relative positioning of the
emitter and the object to which the emitter is attached or
otherwise secured is known (here, an implant), the orientation of
the object may thus also be determined. In other words, the
determining may be based on information about a plurality of
detected signals, information about a position of each speaker
within the emitter, and/or information about a relative position of
the emitter and the object to which the emitter is attached or
otherwise secured.
[0093] The present disclosure encompasses a number of variations on
the method 300. For example, one or more of the steps of the method
300 may be omitted in embodiments of the present disclosure. More
specifically, a method according to embodiments of the present
disclosure may omit one or more of the steps 304, 308, 312, 316,
320, 324, and/or 332 while including the remaining steps of the
method 300. The present disclosure also encompasses methods that
additional steps beyond those described herein with respect to the
method 300. In other words, the present disclosure encompasses
methods that include more or fewer steps (including steps that are
unique from those described herein) than the method 300.
Additionally, although the method 300 is described in connection
with an emitter comprising a speaker and a plurality of microphones
configured to detected a sound emitted by the speaker, other
embodiments of the present disclosure may utilize non-sound signals
for triangulation to determine a position of the emitter (or of one
or more speakers of the emitter, or of an object to which the
emitter is attached). For example, embodiments of the present
disclosure may utilize RF or other electromagnetic signals instead
of sound signals, with a corresponding emitter and plurality of
sensors. Additionally, while the method 300 is described based on
the use of an active emitter and a plurality of sensors configured
only to receive signals generated by a separate emitter, other
embodiments of the present disclosure utilize a plurality of
sensors that includes at least one transceiver capable of
generating a signal, and either a passive emitter configured to
reflect a signal so generated, or an active emitter configured to
receive and respond to the signal. Thus, embodiments of the present
disclosure may utilize RADAR, SONAR, ultrasound, or other
technologies that utilize signal reflection or bounce-back to
determine distance or other information from which a position of an
object may be calculated or otherwise determined.
[0094] Additionally, although various steps of the method 300 are
described in connection with information about a single detected
sound, in embodiments of the present disclosure, a plurality of
sounds may be detected, whether all from the same speaker, or from
a plurality of speakers (each of which may generate one or more of
the detected sounds). For example, where the emitter comprises
three speakers, each speaker may detect a sound, and information
about each of the detected sounds may be used for any purpose
described herein (e.g., to determine position, orientation,
movement, relative position, or otherwise). Each detected sound may
be the same or different (e.g., different frequency, different
amplitude, different pattern of pulses). As another example, each
of a plurality of objects within the patient's body may have an
emitter attached thereto, and one or more sounds may be generated
by one or more speakers corresponding to each emitter. Again,
information about these detected sounds may be used for any purpose
described herein, and each detected sound may be the same or
different.
[0095] The method 300 beneficially enables determination of a
position and even an orientation of an emitter, as well as an
object to which the emitter is attached or otherwise secured. The
object may be a medical device, tool, or implant, or other foreign
object (relative to the patient), or the object may be an
anatomical feature of the patient. Moreover, the method 300
beneficially does not require the use of harmful radiation, nor
does the method 300 require a line of sight between each of the
plurality of sensors and the emitter. The method 300 may be
accomplished automatically during a surgery, without manual
intervention and without consuming valuable time of the operating
room staff. The method 300 beneficially enables operating room
staff to determine and/or track a position, orientation, and/or
movement of one or more objects within a patient's body, thus
enabling improved accuracy and safety during a surgical
procedure.
[0096] With reference now to FIG. 4, a method 400 of using
triangulation to determine a position, movement, and/or orientation
of an object comprises receiving a model of a portion of a
patient's anatomy (step 404). The step 404 may be the same as or
substantially similar to the step 304 described above.
[0097] The method 400 also comprises receiving a surgical plan
comprising information about a planned implant position (step 408).
The surgical plan may be received via a communication interface
such as the communication interface 108, and may be received from
or via a memory such as the memory 116, a database such as the
database 164, and/or a cloud such as the cloud 168. The surgical
plan may comprise information about one or more steps of a surgical
procedure, including one or more planned positions of an implant
during the surgical procedure. The one or more planned positions
may correspond to planned positions of the implant relative to one
or more anatomical features in the model of the portion of the
patient's anatomy, or relative to a coordinate system such as a
predetermined coordinate system 120. The surgical plan may be
combined with or separate from the model of the patient's anatomy
received in the step 404.
[0098] The method 400 also comprises calculating a predicted speed
of sound along at least one path that extends at least partially
through the portion of the patient's anatomy (step 412). The
calculating the predicted speed of sound may be the same as or
substantially similar to the step 308 described above in connection
with the method 300. The calculating may be based at least in part
on the information about the planned implant position, and may
comprise calculating a predicted speed of sound along one or more
paths extending from or proximate the planned implant position to a
surface of the patient's body. The calculated predicted speed of
sound may be updated based on calibration data, which may be
generated and/or received before or during a surgical procedure
corresponding to the surgical plan received in the step 408.
[0099] The method 400 also comprises receiving first detection
information corresponding to a first detected sound generated by a
speaker connected to the implant (step 416). The first detection
information may be the same as or substantially similar to the
information about the detected sound described above in connection
with the step 324. The first detection information may comprise
data received directly or indirectly from a plurality of sensors
such as the plurality of sensors 132, which in this embodiment are
a plurality of microphones.
[0100] The method 400 also comprises determining a position of the
implant (step 420). The determining a position of the implant may
be based on a calculated or otherwise determined position of the
speaker (which may be calculated or otherwise determined in the
same manner or in a substantially similar manner as the calculating
a position of the emitter as described above in connection with the
step 328), as well as based on information about a position of the
speaker relative to a position of the implant (which information
may be stored, for example, in a memory such as the memory 116, or
received via a communication interface such as the communication
interface 108, whether from or via a database such as the database
164, a cloud such as the cloud 168, or elsewhere). Calculating or
otherwise determining a position of the speaker may be accomplished
utilizing triangulation as well as the first detection information,
the predicted speed of sound, information about a position of or
distance between each of a plurality of microphones configured to
detect sound generated by the speaker, and/or any other useful
information.
[0101] The method 400 also comprises receiving second detection
information about a second detected sound (step 424). Receiving the
second detection information about a second detected sound may be
the same as or similar to receiving the first detection information
about the first detected sound, as described above in connection
with the step 416. In the step 424, however, the second detected
sound may be generated by the same speaker that generated the first
detected sound; by a different speaker of the same emitter that
comprised the speaker that generated the first sound; by a
different speaker attached to the same implant (and not comprising
part of the same emitter as the speaker that generated the first
sound); or by a different speaker attached to a different object
(e.g., medical device, tool, implant, or other foreign implant, or
anatomical feature of the patient) than the speaker that generated
the first sound.
[0102] The method 400 also comprises determining a movement or an
orientation of the implant, or a position of the implant relative
to another object (step 428). The determining may comprise first
determining a position of the speaker that generated the second
detected sound. The position of the speaker that generated the
second detected sound may be determined in the same manner or in a
substantially similar manner as described above in connection with
the step 328. The determining (of the step 428) may also comprise
determining a position of an object to which the speaker that
generated the second detected sound is attached, which may be
accomplished based on a determined position of the speaker that
generated the second detected sound as well as based on information
about a relative position of that speaker and the object to which
that speaker is attached.
[0103] Where the second detected sound was generated by the same
speaker as the first detected sound, the step 428 may comprise
determining a movement of the implant. If the determined position
from the step 420 differs from the determined position in the step
428, then the difference in determined positions corresponds to a
movement of the speaker (and thus, of the implant to which the
speaker is attached).
[0104] Where the second detected sound was generated by a different
speaker of the same emitter that comprised the speaker that
generated the first sound, the determined position from the step
420 together with the determined position of the step 428 may be
used to determine an orientation of the emitter, from an
orientation of the object to which the emitter is attached may also
be determined (e.g., using information about a position of the
emitter on the object to which the emitter is attached).
Determining the orientation may be the same as or substantially
similar to determining the orientation of an implant as described
above in connection with the step 332.
[0105] Where the second detected sound was generated by a different
speaker attached to the same implant (and not comprising part of
the same emitter as the speaker that generated the first sound), an
orientation of the implant may be determined directly, without
first determining an orientation of the emitter. The orientation of
the implant may be determined in the same manner or in a
substantially similar manner as described above in connection with
the step 332.
[0106] Where the second detected sound was generated by a different
speaker attached to a different object (e.g., medical device, tool,
implant, or other foreign implant, or anatomical feature of the
patient) than the speaker that generated the first sound, then a
position of the implant relative to a position of the object to
which the different speaker is attached may be determined. Such
information may be useful, for example, to determine a position of
the implant relative to a position of an anatomical feature of the
patient (e.g., where the implant needs to be positioned adjacent to
or otherwise in relation to an anatomical feature of the patient),
or to determine a position of a tool relative to a position of the
implant (e.g., where a tool needs to be connected to the implant,
or where a tool needs to avoid contacting the implant).
[0107] Each detected sound of the method 400 may have a unique
frequency. In some embodiments, such as embodiments in which a
single speaker generates more than one detected sound, each speaker
may be configured to generate sound at a frequency that is unique
from the frequency at which every other speaker is configured to
generate sound.
[0108] The present disclosure encompasses a number of variations on
the method 400. For example, although the method 400 is described
above with respect to the use of speakers and a plurality of
microphones configured to detect one or more sounds generated by
the speakers, in other embodiments the method 400 may utilize, for
example, RF or other electromagnetic waves rather than sound waves,
with corresponding signal generators (instead of speakers) and
sensors (instead of microphones). The method 400 may also be
implemented with a passive emitter rather than a speaker, which
passive emitter may be configured simply to reflect a signal
generated outside of the patient's body (whether by one or more of
the plurality of sensors or by a separate emitter, the position of
which is known). Such embodiments may utilize ultrasound, RADAR,
SONAR, or other technologies for determining a position and/or
orientation of the emitter.
[0109] Additionally, although the method 400 only explicitly
describes the use of information about a first detected sound and
information about a second detected sound, in embodiments of the
present disclosure, a plurality of sounds may be detected, whether
all from the same speaker, or from a plurality of speakers (each of
which may generate one or more of the detected sounds). For
example, where an emitter attached to the implant comprises three
speakers, and additional emitters comprising three speakers each
are attached to a plurality of anatomical features in the area
where the implant is to be inserted as well as to one or more tools
that will be used during a surgical procedure involving the implant
(or involving a portion of the patient's anatomy in which the
implant is positioned), then a position and/or orientation of each
of the emitters (and thus of each of the objects to which the
emitters are attached) may be determined, as well as any movement
of such emitters (and thus of the objects to which the emitters are
attached), and a position of one emitter relative to any other
emitter (and thus of one object to which an emitter is attached
relative to any other object to which another emitter is
attached).
[0110] Like the method 300, the method 400 beneficially enables
determination of a position and even an orientation of an emitter,
as well as an object to which the emitter is attached or otherwise
secured. The method 400 also enables detection of movement of an
emitter (as well as an object to which the emitter is attached) and
of a position of one emitter relative to a position of another
emitter (as well as objects to which the emitters are attached).
Moreover, the method 400 beneficially does not require the use of
harmful radiation, nor does the method 400 require a line of sight
between each of the plurality of sensors and the emitter. The
method 400 may be accomplished automatically during a surgery,
without manual intervention and without consuming valuable time of
the operating room staff. The method 400 beneficially enables
operating room staff to determine and/or track a position,
orientation, and/or movement of one or more objects within a
patient's body, thus enabling improved accuracy and safety during a
surgical procedure.
[0111] Any signal generator described herein (such as the signal
generator 176) may be used in place of any speaker described
herein, and any sensor described herein (such as the sensor 212)
may be used in place of any microphone described herein, provided
that the sensor is configured to receive or detect signals
generated by the signal generator, and the signal generator is
configured to generate signals detectable and receivable by the
sensor.
[0112] Although both of the methods 300 and 400 are described as
comprising the step of receiving a model of a portion of a
patient's anatomy, and also as comprising the step of calculating a
predicted speed of sound through at least a segment of the portion
of the patient's anatomy (method 300) or along at least one path
that extends at least partially through the portion of the
patient's anatomy (method 400), embodiments of the present
disclosure do not require either or both of these limitations. For
example, when a surgical procedure is an open procedure (rather
than, for example, a minimally invasive procedure), a line of sight
may exist between the emitter (whether a speaker or otherwise) and
the sensors (whether microphones or otherwise), such that the
signal generated by the emitter need not travel through the
patient's anatomy to reach the sensor, and no adjustment need be
made for the speed of the signal based on interference from the
patient's anatomy. Also, although the methods 300 and 400 are
described as including steps regarding calculating a predicted
speed of sound to address interference from the patient's anatomy,
embodiments that use other types of signals may comprise
corresponding steps regarding calculating a predicted speed at
which a signal of the type in question will travel through the
patient's anatomy.
[0113] As may be appreciated based on the foregoing disclosure, the
present disclosure encompasses methods with fewer than all of the
steps identified in FIGS. 3 and 4 (and the corresponding
description of the methods 300 and 400), as well as methods that
include additional steps beyond those identified in FIGS. 3 and 4
(and the corresponding description of the methods 300 and 400). The
present disclosure also encompasses methods that combine one or
more steps of the method 300 with one or more steps of the method
400 or vice versa.
[0114] Embodiments of the present disclosure may also be used to
located items not positioned within a patient's body. For example,
an emitter could be attached to each of one or more robots,
instruments, tools, imaging devices, and/or other systems or
devices within an operating room, and the systems and methods
described herein may be used to track a location or position of
each such object during a surgical procedure. In such embodiments,
the tracked location or position may be used to ensure that no
unwanted objects are placed in or left behind in a patient's body;
to enable a robot operating autonomously or semi-autonomously to
avoid a collision with another tracked object; to facilitate proper
positioning of a robot, an imaging device, a medical instrument or
tool, or any other object relative to another object; or for any
other useful purpose. Where an emitter is placed on one or more
anatomical features of a patient, embodiments of the present
disclosure may be used for segmental tracking.
[0115] The foregoing is not intended to limit the disclosure to the
form or forms disclosed herein. In the foregoing Detailed
Description, for example, various features of the disclosure are
grouped together in one or more aspects, embodiments, and/or
configurations for the purpose of streamlining the disclosure. The
features of the aspects, embodiments, and/or configurations of the
disclosure may be combined in alternate aspects, embodiments,
and/or configurations other than those discussed above. This method
of disclosure is not to be interpreted as reflecting an intention
that the claims require more features than are expressly recited in
each claim. Rather, as the following claims reflect, inventive
aspects lie in less than all features of a single foregoing
disclosed aspect, embodiment, and/or configuration. Thus, the
following claims are hereby incorporated into this Detailed
Description, with each claim standing on its own as a separate
preferred embodiment of the disclosure.
[0116] Moreover, though the description has included description of
one or more aspects, embodiments, and/or configurations and certain
variations and modifications, other variations, combinations, and
modifications are within the scope of the disclosure, e.g., as may
be within the skill and knowledge of those in the art, after
understanding the present disclosure. It is intended to obtain
rights which include alternative aspects, embodiments, and/or
configurations to the extent permitted, including alternate,
interchangeable and/or equivalent structures, functions, ranges or
steps to those claimed, whether or not such alternate,
interchangeable and/or equivalent structures, functions, ranges or
steps are disclosed herein, and without intending to publicly
dedicate any patentable subject matter.
* * * * *